Radiation Safety Information for Duke Patients and Their Families

Duke University Medical Center enjoys national prominence in the treatment of patients with cancer and other conditions. Radioactive drugs and radiation sources are commonly employed in the diagnosis and therapy of our patients. Some of these procedures may result in radiation exposure to our patients' family members and friends.
It is important to remember that in no case will radiation exposure from a patient present an immediate danger to others. The risk, if any, to friends and family is minimal and is easily managed using common-sense methods.

The purpose of this page is to inform Duke patients, in general terms, about the impact of this care on their interactions with their families. If you are a patient and have questions about the radiation exposure you will receive from a specific test or treatment, please consult the physician administering the procedure.

Nuclear Medicine Diagnostic Procedures

You may undergo imaging procedures in Nuclear Medicine while hospitalized, or as an outpatient. These procedures include bone scans, gallium scans, "MUGA" scans, PET scans and so forth. They are performed using very small ("tracer") amounts of a radioactive drug that is injected into a vein or given by mouth. The radioactive drug is rapidly removed from your body by physical and biological processes. While in your body, the radioactive material emits gamma radiation, which is similar in quality to x-rays. These gamma radiation levels are very low, and present virtually no risk to your family members or other people you may encounter. No special precautions are necessary for diagnostic procedures.

Nuclear Medicine Therapy Procedures

You will most likely be treated with radioactive iodine-131 (I-131). Iodine-131 has a half-life of 8 days and emits both beta particles and gamma rays. The beta particles are responsible for killing tumor cells or reducing the metabolic activity of "hyperactive" normal cells. Beta particles have such a short "range" in tissue that they do not leave your body, and so present no external hazard to your family. However, if any I-131 is unintentionally ingested, the beta particles produce internal exposure. Because I-131 is excreted in your urine, saliva and perspiration, small amounts of radioactivity may be present on surfaces in your household. This "contamination" can be ingested by family members through "surface-to-hand-to-mouth" contact.

The gamma rays have properties like x-rays. They pass out of your body, and therefore may give external exposure to bystanders. In most cases, the exposure to others is small and you can be treated as an outpatient. In some cases, you may be hospitalized in a special lead-lined room until your radiation levels fall into the range where you may be discharged.

At the time of your discharge, technologists from the Duke Radiation Safety Division will interview you about your home and work situation, and give you a set of specific post-discharge instructions that will tell you how to mimnimize radiation exposure to others. These instructions may include measures such as the following:

(1) Sleeping in a separate bed for a period of time.
(2) Using separate bathroom facilities from the rest of the family.
(3) Maintaining a distance of six feet or more from children or pregnant women.
(4) Eating using disposable plates and utensils.
(5) Washing your clothing separately from that of others.
(6) Bathing or showering frequently.

The length of time you'll observe these precautions will depend upon the type of treatment you have. In no case will radiation exposure present any immediate danger to your family members. The purpose of these precautions is to ensure that the exposure to your family and others is as low as reasonably achievable. Your Radiation Safety Technologist or Nuclear Medicine Technologist will be available to discuss any specific questions or concerns you may have.

Other radioactive drugs besides I-131 are used therapeutically. You may treated with a radioactive drug that emits only pure beta particles. These drugs include phosphorus-32 (P-32), strontium-89 (MetastronTM), yttrium-90 (ZevalinTM) and samarium-153 (QuadrametTM). You will not require hospitalization for radiation protection purposes, since there is no external hazard from these treatments. Your Radiation Safety Technologist or Nuclear Medicine Technologist will inform you of any recommended precautions specific to your treatment.

Brachytherapy (Implant) Procedures

In cases where their tumors are close to accessible body cavities, oncology patients may undergo a procedure called brachytherapy, or "implant" therapy. Implant therapy is effective in some cases of uterine, prostate and lung cancer. In implant therapy, a sealed source of radioactive material, usually a gamma emitter, is placed in a body cavity close to the tumor and left in place for a prescribed period of time. During the time the implant is in place, bystanders are exposed to gamma rays and must take precautions.

For some treatments, you may be hopitalized in a lead-lined room to minimize radiation exposure to others. Visitors may not be permitted during this time. The implant is in place for 72 hours or less and then removed. Once the treatment is completed and the implant is removed, you are no longer radioactive and do not expose others to radiation.

For other treatments, the implants may be left in place permanently. Usually the radiation levels are so low that no special precautions are needed following discharge. As time passes, the radiation levels continuously decrease over a period of days to weeks until they can no longer be detected. Your Radiation Oncologist, Medical Physicist or Radiation Safety Technologist will advise you of any precautions specific to your treatment.

Important Information Concerning This On-line Material

This information is for use by Duke University Medical Center patients and their families. It is not intended be used as a primary source for information on the release of patients containing radioactive material from confinement, nor as a source of medical information. Individuals with concerns regarding the consequences of their radiation exposure due to medical procedures should discuss them with their physicians.